Americans had poor oral hygiene in Lincoln's era.Rotten teeth and foul breath were common (halitosis was not yet a social evil). Calomel frequently prescribed by doctors for fevers caused many people to have loose teeth. Dentistry was plagued by ignorance and quackery. Barbers were the usual practitioners of tooth extraction, wielding the dreaded "turn-key" (pictured below) used to twist out stubborn teeth. Various craftsmen tinkered at creating dentures, including carved ivory, metal plates that occasionally featured old sheep;s teeth, or even hickory plugs soaked in creosote. After Dr. Amos W. French arrived from New York in 1848, he soon acquired a reputation as one of the best "mechanical dentists" in the West. He was also a book collector; his upper-floor office looked more like a library than a dentist's office. He and Lincoln studied German together—-but Lincoln kept the class in turmoil with his storytelling. After the Civil War, French participated in the scientific revolution that transformed the dental profession.

Lincoln had a bad experience with a dentist before Dr. French arrived. In an 1841 letter, he wrote about having a painful tooth extracted: "I had it torn out, bringing with it a bit of the jawbone; the consequence of which is that my mouth is now so sore that I can neither talk, nor eat." An 1843 store account shows that Lincoln bought a toothbrush. Perhaps this reflects Mary's refining influence. As president, he took precautions when visiting the dentist, for he reportedly took along a small bottle of chloroform to help deaden the pain of having a tooth pulled. When the doctor approached with forceps, Lincoln surprised him by administering the analgesic to himself before proceeding. The practice of analgesia in dentistry was not common at the time.

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